Combined Lynch Incision (Transfacial Medial Orbitotomy) and Endoscopic Endonasal Approach for Atypical Solitary Fibrous Tumor Involving the Orbitonasal Junction With an 18-Year Course of Four Recurrences: A Case Report

Solitary fibrous tumor (SFT) is a rare mesenchymal neoplasm, and its involvement at the orbitonasal junction is exceptionally uncommon. We report an extremely rare case of atypical SFT arising at the orbitonasal junction in a patient with an 18-year history of recurrent left orbital mass who had undergone multiple excisions and eventual enucleation, and finally presented with extensive osteolytic destruction extending into the nasal cavity and paranasal sinuses. After preoperative evaluation, a combined surgical approach using Lynch incision (transfacial medial orbitotomy) and endoscopic endonasal resection successfully achieved complete tumor removal and orbital reconstruction. Histopathology and immunohistochemistry (STAT6+, CD34+, Ki-67 20%) confirmed the diagnosis of atypical SFT.This case enriches the clinical literature on this rare entity and offers a surgical reference for orbitonasal SFT.